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Sero -ve symptoms but ive blood test - Help!

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Sammo, Feb 25, 2010.

  1. Sammo

    Sammo Active Member


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    Sero -ve symptoms but -ve blood test - Help!

    Hi Guys and Gals,

    Has anyone come across symptoms similar to sero -ve arothropathy but with a negative blood test? I referred the patient to Rheum, she had exhaustive blood tests, x-rays of hands (some IPJ arthirtic changes), feet and knees (L knee ok R knee Patella tracking more laterally and some lose fragments in the joint). Blood tests showed decreased Calcium and Vit B. Slightly increased WBC. Nil else of note

    Here is my letter to rheum:

    Mdm. Zaphodbeeblebrox [name changed to protect the innocent] attended my clinic today c/o 6/12 hx of left knee pain, which I have diagnosed as pes anserinus bursitis and will be treating with stretching and foot orthoses to control internal knee rotation. She also presents with bilateral hallux valgus which I believe to be of mechanical origin.

    The reason for my referral is that the patient informed me today that over the last ten years she experiences episodes of pain and swelling in many different joints in the body including the interphalangeal joints of the fingers and the MTPJ’s in the feet. She states that it always changes location on each new episde. She also c/o long term pain the shoulders and upper back/neck and left side of the lower back.

    The swelling and pain in the fingers and toes lasts for 2-3 weeks and once it subsides the patient reports that the affected joint remains slightly deformed.

    I can attribute much of the foot pain to mechanical cause, however with the swelling in the fingers and the patients reported history I feel that the patient should see Rheumatology for your specialist input and assessment to rule out any undiagnosed arthropathy.


    Rheumatologist also agreed symptoms looked like polyarthropathy and is following up in March.

    Just want to know if anyone else has come across anything similar, or has any ideas what it might be?

    BTW L knee pain resolved with Tx and R knee pain reduced in symptoms.

    Kindest Regards..

    Sam
     
    Last edited by a moderator: Feb 25, 2010
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Re: Sero -ve symptoms but -ve blood test - Help!

    Not sure what blood test that would be as there is not one fro sero -ve.

    Its migratory polyarthritis - most of them takes years to reach an actual 'pattern' before an diagnosis is made. Rheumatological diagnoses are all about 'pattern recognition' -- it can takes years for the full pattern to manifest.
     
  3. Sammo

    Sammo Active Member

    Re: Sero -ve symptoms but -ve blood test - Help!


    Thanks Craig,

    My Rheumatology clearly isnt wonderful.. But it was my understanding if someone had some kind of polyarthritis there would be indicators in their bloodwork?

    Not heard of migratory polyarthritis and would like to learn more.. can you point me toward some info on it please?

    S
     
  4. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Migratory polyarthritis is not a diagnosis - its a pattern of joint involvement:

    1. Migratory (comes and goes in different joints)
    2. Poly (affects lots of joints as opposed to mono- (one joint) or pauci- (a few joints))
    3. Arthritis (obviously joint pain and inflammation)
    (4. Symmetrical or Asymmetrical).

    Classically, rheumatoid arthritis is a symmetrical polyarthritis and the sero -ve's are an asymmetrical polyarthritis (neither tend to be migratory)

    For a diagnosis to be made, it recognising the pattern
     
  5. G Flanagan

    G Flanagan Active Member

    HLA-B27 not definitive, but its a test
     
  6. Re: Sero -ve symptoms but -ve blood test - Help!

    Sam and Others:

    I've seen you guys use this abbreviation -ve +ve for some time now and I don't have a clue what it means. If you all want everyone reading your posts from multiple countries to understand exactly what you are saying, then you need to quit using so many abbreviations and acronyms because not all of us use the same abbreviations and acronyms and, therefore, don't know what they mean!
     
  7. G Flanagan

    G Flanagan Active Member

    Kevin,

    -ve = negative

    +ve = positive
     
  8. Sammo

    Sammo Active Member

    Apologies Kevin.

    Didn't occur to me that the abbreviation might not be universal.

    S
     
  9. On Podiatry Arena, since we have a truly international audience, we should all assume that there is no such thing as a universal abbreviation!

    Therefore, in your first posting, I have highlighted all the abbreviations you have used which may have absolutely no meaning to many of those following along here on Podiatry Arena from many countries around our small planet.

    Sam, I am not trying to pick on you, because you are certainly not alone. However, if you, and everyone else who uses lots of abbreviations and acronyms on Podiatry Arena, want everyone following along to have the best chance of understanding exactly what you are trying to say, then spell out your abbreviations such as metatarsophalangeal joint (MTPJ) so that the next time you use the word MTPJ in the posting, everyone will fully understand what you are talking about.

    My desire is to help make Podiatry Arena the most professional-looking medical academic website on the internet since this will, in the years to come, shine an increasingly brighter light on the podiatric profession around the world. If you, and others, share my feelings in this regard, then I will need all of your help in order to accomplish this goal!:drinks
     
  10. cornmerchant

    cornmerchant Well-Known Member

    Kevin

    While you are making the site universal, could you please ask our Spanish colleagues to provide a translation? There has been an interesting thread on there that I cannot follow .

    Cornmerchant
     
  11. admin

    admin Administrator Staff Member

    There is a translate button at the bottom of every page.
     
  12. Paul Bowles

    Paul Bowles Well-Known Member

    OUCH!
     
  13. Corn:

    I want the English speaking people, who know how to write correct English, to do so. Nothing more, nothing less.
     
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